Chemical Dependency Counselor CCDC Exam Risk Assessment & Management 4 — Questions and Answers
Question 1: Which tool is specifically designed to assess withdrawal risk from benzodiazepines and alcohol in a medical setting?
- AUDIT
- CIWA-Ar (Correct answer)
- COWS
- DAST-10
Correct answer: CIWA-Ar
The Clinical Institute Withdrawal Assessment for Alcohol–Revised (CIWA-Ar) measures the severity of alcohol and sedative withdrawal symptoms.
Question 2: A client with opioid use disorder refuses naloxone education. The most appropriate counselor response is to:
- Document refusal and discharge the client
- Respect the refusal but continue to offer education at future sessions (Correct answer)
- Require acceptance as a condition of continued treatment
- Notify law enforcement of the risk
Correct answer: Respect the refusal but continue to offer education at future sessions
Counselors should respect client autonomy, document the refusal, and revisit harm reduction education when the client is more receptive.
Question 3: The Addiction Severity Index (ASI) assesses risk and functioning across how many life domains?
- 4
- 5
- 7 (Correct answer)
- 9
Correct answer: 7
The ASI evaluates seven domains: medical, employment, alcohol, drug, legal, family/social, and psychiatric.
Question 4: A client who is homeless and using methamphetamine daily is assessed for level of care. Which ASAM criterion most directly addresses immediate safety needs?
- Dimension 3: Emotional/Behavioral Conditions
- Dimension 1: Acute Intoxication and Withdrawal Potential (Correct answer)
- Dimension 6: Recovery Environment
- Dimension 4: Readiness to Change
Correct answer: Dimension 1: Acute Intoxication and Withdrawal Potential
ASAM Dimension 1 addresses acute intoxication and withdrawal potential, which is the most immediate physical safety concern.
Question 5: In motivational interviewing, how does a counselor best address a client who minimizes the risks of their substance use?
- Provide a stern lecture on health consequences
- Use reflective listening and explore discrepancy between values and behavior (Correct answer)
- Challenge the client's denial directly
- Refer immediately to a higher level of care
Correct answer: Use reflective listening and explore discrepancy between values and behavior
MI relies on exploring discrepancies and using empathic reflection rather than confrontation to evoke the client's own motivation for change.
Question 6: A counselor receives a subpoena for a client's treatment records. The appropriate first step is to:
- Release records immediately to comply with court order
- Consult with a supervisor or legal counsel before releasing any records (Correct answer)
- Destroy the records to protect client confidentiality
- Notify the client and obtain written consent before any action
Correct answer: Consult with a supervisor or legal counsel before releasing any records
A subpoena alone does not override 42 CFR Part 2 protections; legal consultation is required before releasing SUD treatment records.
Question 7: Which scenario represents the highest combined suicide and overdose risk?
- A client with mild alcohol use and no psychiatric history
- A client with opioid use disorder, recent loss, and prior suicide attempt (Correct answer)
- A client in early recovery with strong family support
- A client with cannabis use disorder and stable housing
Correct answer: A client with opioid use disorder, recent loss, and prior suicide attempt
Co-occurring opioid use disorder, recent major stressor, and prior suicide attempt represent a convergence of the most significant risk factors.
Chemical Dependency Counselor CCDC Exam Risk Assessment & Management 4
Which tool is specifically designed to assess withdrawal risk from benzodiazepines and alcohol in a medical setting?